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http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/06000/Best_Practices_in_Urinary_Catheter_Care.5.aspx
Urinary catheterization is a common healthcare intervention used to manage urinary dysfunction that poses serious associated risks and complications. This article discusses methods of urinary catheterization and their indications, catheter-associated complications, and assessment and management strategies that home healthcare practitioners can employ to ensure best patient outcomes and minimize complications.]]>Tue, 01 Jun 2010 00:00:00 GMT-05:0000004045-201006000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/07000/Say_Goodbye_to_Wet_to_Dry_Wound_Care_Dressings_.8.aspx
No abstract available]]>Fri, 01 Jul 2011 00:00:00 GMT-05:0000004045-201107000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Bag_Technique__Preventing_and_Controlling.6.aspx
The nursing bag has been used by home care visiting staff for decades to carry needed equipment and supplies to provide patient care in the home. The nursing bag is transported from patient home to home and may serve as a vehicle for transmitting microorganisms by virtue of the bag's contact with the staff's hands and contact with the patient's environment. This article establishes guidelines for the management of the nursing bag used by home care and hospice staff and offers strategies to prevent and control the transfer of microorganisms through its use.]]>Wed, 01 Jan 2014 00:00:00 GMT-06:0000004045-201401000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/02000/Improving_Pain_Outcomes_in_Home_Health_Patients.3.aspx
Abstract: Pain is often undertreated and underreported in the elderly. Many of these individuals receive home healthcare services for management of their conditions. Home healthcare agencies (HHAs) have outcome measures that are publicly reported. The purpose of this project was to implement an evidence-based (EB) guideline bundle to improve the outcome measure “Improvement in Pain Interfering With Activity.” This quality improvement (QI) project used a pre-/posttest design. The setting was a hospital-based HHA in Arizona. The target sample included Medicare patients with chronic pain and pain that interfered with activity. The approach included a review of published clinical practice guidelines addressing pain management, and identification of relevant interventions for the home healthcare setting. A bundle of three interventions was created for implementation. Clinical staff was educated on use of the bundle. Chart audits were conducted on patients meeting the inclusion criteria to determine if the bundle was used, and if the patient had an improvement in pain. There was a statistically significant improvement in the outcome “pain interfering with activity” in the patients who had the bundle (78% vs. 48%) used in their care (p = 0.007). Clinical staff readily incorporated use of the bundle into their practice, showing that implementation of an EB guideline bundle is an effective way to incorporate EB practices into the home healthcare setting.]]>Sun, 01 Feb 2015 00:00:00 GMT-06:0001845097-201502000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/02000/An_Evidence_Based_Pediatric_Fall_Risk_Assessment.8.aspx
No abstract available]]>Tue, 01 Feb 2011 00:00:00 GMT-06:0000004045-201102000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/02000/Skin_Tears__Care_and_Management_of_the_Older_Adult.8.aspx
Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.]]>Fri, 01 Feb 2013 00:00:00 GMT-06:0000004045-201302000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Bag_Technique__Preventing_and_Controlling.7.aspx
No abstract available]]>Wed, 01 Jan 2014 00:00:00 GMT-06:0000004045-201401000-00007http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/02000/Innovative_and_Successful_Approaches_to_Improving.7.aspx
Abstract: Effective transitions to home care have been identified as among the factors leading to reducing hospital readmissions within 30 days of discharge and improvements on various other quality measures. Innovative applications of published evidence-based models and best practices designed to improve care transitions have been implemented in various settings across the country in an effort to enhance quality performance. For this article, The Joint Commission collected a series of case examples to examine how evidence-based innovations in care transitions are reducing readmissions and improving other quality outcomes. The organizations providing the case examples were interviewed and asked to provide performance data demonstrating quality improvement, as well as information about their care processes and data-gathering techniques. Their innovative approaches are reducing hospital readmissions; improving patient safety, satisfaction, and engagement; and contributing to other positive outcomes.]]>Sun, 01 Feb 2015 00:00:00 GMT-06:0001845097-201502000-00007http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/09000/Root_Cause_Analysis__Responding_to_a_Sentinel.6.aspx
Adverse events, including sentinel events, require comprehensive review to improve patient safety and reduce healthcare errors. Root cause analysis (RCA) provides an evidence-based structure for methodical investigation and comprehensive review of an event enabling appropriate identification of opportunities for improvement. Use of RCA is described in the home care setting.]]>Sun, 01 Sep 2013 00:00:00 GMT-05:0000004045-201309000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Validating_a_Multifactorial_Falls_Risk_Assessment.3.aspx
Reducing risk of falls has been identified as a national safety goal by The Joint Commission (TJC). The purpose was to determine if the total score on the multifactorial Falls Risk Assessment accurately identifies the risk of falls in a homebound client. In addition, the study examined if any individual item had a higher predictive power with the incidence of falls. One hundred clients (> 65 years old) who sustained an avoidable fall during a home care episode of care, plus 25 home care clients in the same age range and time period, who did not fall. A retrospective chart review, including Falls Risk Assessment (FRA) performed at start of care, demographic information, specific physical therapy (PT) evaluation, and visit notes if necessary to determine if the fall met the inclusion criteria. Scores for each individual area of the assessment were collected for statistical analysis. Data were analyzed by a biostatistician using simple linear regression, t-tests, and regression of variable combinations. The total score on the multifactorial risk assessment tool was shown to have a strong relationship with incidence of falls. The average scores of individuals who fell after assessment were significantly higher than those of individuals who did not fall. No single factors were found to be highly predictive. A single approach to decreasing falls is likely to be less effective than a multipronged approach. Caregivers and providers are advised to consider the entirety of the falls risk and direct comprehensive interventions to address the multiple factors that lead to falls.]]>Wed, 01 Jan 2014 00:00:00 GMT-06:0000004045-201401000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/10000/Ensuring_Effective_Medication_Reconciliation_in.2.aspx
A patient was readmitted two days after discharge with severe hypoglycemia. The treating team discharged the patient on a new insulin regimen without realizing that the patient also had insulin 70/30 at home. The patient continued to take her previous regimen as well as the new one, and was found unresponsive by her husband. The patient was in the ICU with the incident likely resulting in permanent neurological deficits. (Fernandes & Shojania, 2012)
A patient was admitted to a hospital from a home health agency. The list of medications provided by the agency did not completely match the list provided by the patient's family physician (i.e., the antihypertensive agent metoprolol tartrate [Lopressor] was not listed by the agency as one of the medications that the patient was currently taking). Therefore, metoprolol tartrate was not initially ordered. The patient developed atrial fibrillation shortly after hospital admission and required a transfer to the ICU [intensive care unit]. A diltiazem (Cardizem) infusion was started and the patient's family physician became aware that the patient had not been receiving their antihypertensive medication and initiated an order for the metoprolol tartrate (United States Pharmacopeia, 2005)]]>Wed, 01 Oct 2014 00:00:00 GMT-05:0000004045-201410000-00002http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/04000/Parenteral_Inotropic_Therapy_in_the_Home__An.4.aspx
This article provides an evidence-based overview of heart failure (HF), including its pathogenesis, staging, assessment, prognosis, and treatment with intravenous inotropic medications in the home. Inotropic infusions in the home setting require advanced care planning, symptom management, and knowledge about ambulatory pumps and devices. These medications can be safely used throughout the continuum of care as pediatric/adult bridges from transplant to hospice care. Nurses who recognize advanced HF symptomatology and use prognostic/risk-stratification models will be better prepared to facilitate this advanced care planning, thus supporting optimal treatment outcomes. The ultimate goal of care for heart failure therapy in the home is to integrate pharmacotherapeutic knowledge of treatment advances with comfort measures and to provide them to patients concurrently and in a seamless process.]]>Mon, 01 Apr 2013 00:00:00 GMT-05:0000004045-201304000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/11000/The_Advanced_Practice_Wound_Ostomy_Continence.5.aspx
Wound ostomy continence (WOC) programs are essential in any healthcare organization, including home care agencies, to provide comprehensive, high-quality care. Advanced practice nurses (APNs) with assessment, diagnostic, and coordination skills are well suited to manage the complex patients being cared for by home care agencies. A number of research studies have assessed the credibility and value of APNs in the home care setting, caring for complex, frail patients. This article describes the role of the APN, and the role of the WOC specialist nurse, comparing similarities and differences. The advanced practice WOC nurse is now essential in the home care setting to manage the care of complex patients.]]>Thu, 01 Nov 2012 00:00:00 GMT-05:0000004045-201211000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/10000/Using_SBAR_Communications_in_Efforts_to_Prevent.9.aspx
No abstract available]]>Tue, 01 Oct 2013 00:00:00 GMT-05:0000004045-201310000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/04000/Central_Venous_Access_Device_Associated.4.aspx
Central venous access devices (CVADs) are commonly used for patients who require home infusion therapy. CVAD-associated infections are preventable with attention to hand hygiene, site assessment and care, use of aseptic technique with all infusion therapy-related procedures, and thorough patient education.]]>Thu, 01 Apr 2010 00:00:00 GMT-05:0000004045-201004000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/06000/Insulin.9.aspx
No abstract available]]>Sun, 01 Jun 2014 00:00:00 GMT-05:0000004045-201406000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/05000/Assessing_Risk_for_Violence_on_Home_Health_Visits.5.aspx
The objective of this study was to develop and test measures for assessing risk of violence toward staff during home visits. Home visiting health workers from public and private home visiting programs in a Mid-Atlantic state (n = 130) were surveyed to assess exposure to risky home visits, verbal and physical violence, and workplace violence safety climate. Two measures demonstrated evidence of reliability and validity moving the safety research closer to developing tools and processes for protecting home care clinicians. ]]>Sat, 01 May 2010 00:00:00 GMT-05:0000004045-201005000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/06000/Pressure_Ulcers_at_End_of_Life__An_Overview_for.5.aspx
No abstract available]]>Wed, 01 Jun 2011 00:00:00 GMT-05:0000004045-201106000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/03000/Using_Palliative_Care_Assessment_Tools_to.3.aspx
The Palliative Care Outcomes Collaboration focuses on supporting palliative care services in Australia to measure service- and patient-level outcomes, and to use these data to drive continuous quality improvement. The introduction of a suite of clinical assessment tools nationally has resulted in important enhancements to care provision at individual service level. Improved communication, enhanced assessment of patient needs, and improved identification of triggers for the need to change care plans or for referral have resulted from this change.]]>Tue, 01 Mar 2011 00:00:00 GMT-06:0000004045-201103000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/04000/Preventing_Infections_in_Patients_Using.3.aspx
Although respiratory infections are not as common as other types of infections that may develop in home care and hospice patients, respiratory infections can result from the use of medical devices and respiratory supplies. These devices can contribute to the home care or hospice patient developing a respiratory infection by serving as a reservoir and supporting the growth of microorganisms and by directly infecting patients when this equipment becomes contaminated. This article presents evidenced-based guidelines and recommendations on the preferred methods for managing respiratory equipment and supplies commonly used by patients in the home setting and conducting surveillance activities to ultimately prevent respiratory infections.]]>Thu, 01 Apr 2010 00:00:00 GMT-05:0000004045-201004000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/11000/Avoiding_Emergency_Department_Visits_for_COPD,.3.aspx
Abstract: Patients with pneumonia, chronic obstructive pulmonary disease (COPD), and heart failure make frequent visits to the emergency department. Heart failure alone is the reason for more than 1 million emergency department visits annually in the United States. This article describes strategies home care clinicians can use to prevent unnecessary emergency department visits for patients with pneumonia, COPD and heart failure.]]>Sat, 01 Nov 2014 00:00:00 GMT-05:0000004045-201411000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/01000/Home_Care_Nurses__Experiences_With_and_Perceptions.7.aspx
Self-neglect is a poorly understood phenomenon evident to home healthcare nurses who describe older adults who self-neglect as disheveled, unkempt individuals living in cluttered, filthy homes. In spite of the concerns nurses report about these individuals and their situations, individuals who self-neglect give no indication there is any reason for concern for their welfare, and in fact some refuse intervention. The purpose of this study was to determine how home healthcare nurses perceive elder self-neglect, their experiences with this phenomenon, and to explore the steps nurses take when self-neglect is suspected]]>Thu, 01 Jan 2015 00:00:00 GMT-06:0001845097-201501000-00007http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/07000/Reducing_Catheter_Associated_Urinary_Tract.6.aspx
The Performance Improvement Department of one home healthcare agency (HHA) identified an increase in the rate of catheter-associated urinary tract infections (CAUTI) during 2009. An investigation was undertaken to identify factors that contributed to this increase and an action plan was implemented to reduce the rate of infections. Modifications were made to the surveillance process to align the infection rate calculation with Centers for Disease Control and Prevention (CDC) guidelines and staff education was undertaken to ensure utilization of evidence-based practice. An overall reduction in the CAUTI rate was achieved through this multifactorial approach.]]>Sun, 01 Jul 2012 00:00:00 GMT-05:0000004045-201207000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/07000/Best_Practices_for_Heart_Failure__A_Focused_Review.4.aspx
Heart failure (HF) is a progressive condition and is associated with high patient mortality rates and frequent hospitalizations. This article provides an overview of clinical, self-management support, and care transitions best practices for HF care in the home care sector. Clinicians armed with competencies in HF management are positioned to meet the 3-part aim of healthcare reform: improved health, better care, and lower cost.]]>Sun, 01 Jul 2012 00:00:00 GMT-05:0000004045-201207000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/01000/Demystifying_the_Role_of_Nurse_Practitioners_in.13.aspx
No abstract available]]>Sun, 01 Jan 2012 00:00:00 GMT-06:0000004045-201201000-00013http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/07000/Reducing_Catheter_Associated_Urinary_Tract.7.aspx
No abstract available]]>Sun, 01 Jul 2012 00:00:00 GMT-05:0000004045-201207000-00007http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/01000/Palliative_Wound_Care__Principles_of_Care.8.aspx
Home care nursing occurs in a complex care environment. Nurses working in this setting care for a wide array of individuals who often are sicker and more complex than ever before. The high prevalence of wounds among these individuals requires that home care nurses have a certain level of knowledge to provide excellent care. Many times, individuals with wounds do not have the capacity to heal or are burdened with numerous symptoms affecting quality of life. In these cases, the home care nurse must understand concepts of palliative wound care to alleviate symptoms with the goal of improving quality of life.]]>Wed, 01 Jan 2014 00:00:00 GMT-06:0000004045-201401000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/03000/The_Management_of_Respiratory_Insufficiency_in.9.aspx
Amyotrophic lateral sclerosis (ALS) is a devastating motor neuron disease causing progressive paralysis and eventual death, usually from respiratory failure. Treatment for ALS is focused primarily on optimal symptom management because there is no known cure. Respiratory symptoms that occur are related to the disease process and can be very distressing for patients and their loved ones. Recommendations on the management of respiratory insufficiency are provided to help guide clinicians caring for patients with ALS.]]>Thu, 01 Mar 2012 00:00:00 GMT-06:0000004045-201203000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/06000/Best_Practices_in_Urinary_Catheter_Care.6.aspx
No abstract available]]>Tue, 01 Jun 2010 00:00:00 GMT-05:0000004045-201006000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/02000/The_Role_of_a_Pharmacist_on_the_Home_Care_Team__A.6.aspx
Medication-related problems are common among home care clients who take many medications and have complex medical histories and health problems. Helping clients manage medications can be a challenge for all home care clinicians. By partnering with a college of pharmacy at a large university in the community, the agency successfully included a pharmacist as a member of their home care team.]]>Fri, 01 Feb 2013 00:00:00 GMT-06:0000004045-201302000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/05000/Wound_Care_Dressings_and_Choices_for_Care_of.6.aspx
Statistics from various resources report that many patients in home healthcare settings have wounds. These vary from surgical, pressure, neuropathic, trauma, stasis, and venous wounds. These require the assessment, knowledge, and expertise of a clinician to assist them with wound care management. The purpose of this article is to identify and categorize types of wound care products appropriate for the various types of wounds that clinicians care for and manage in the home.]]>Wed, 01 May 2013 00:00:00 GMT-05:0000004045-201305000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/03000/Role_of_the_Wound_Ostomy_Continence_Nurse_in_the.8.aspx
No abstract available]]>Tue, 01 Mar 2011 00:00:00 GMT-06:0000004045-201103000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/04000/Care_at_Home_of_the_Patient_with_Advanced_Multiple.6.aspx
No abstract available]]>Thu, 01 Apr 2010 00:00:00 GMT-05:0000004045-201004000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/02000/Improving_Pain_Outcomes_in_Home_Health_Patients.4.aspx
No abstract available]]>Sun, 01 Feb 2015 00:00:00 GMT-06:0001845097-201502000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/10000/Assessment_of_Surgical_Wounds_in_the_Home_Health.4.aspx
The number of surgical patients receiving home care continues to grow as hospitals discharge patients sooner. Home health clinicians must gain knowledge of the wound healing stages and surgical wound classification to collect accurate data in the Outcome and Assessment Information Set-C (OASIS-C). This article provides the information clinicians need to accurately assess surgical wounds and implement best practices for improving surgical wounds in the home health patient.]]>Sat, 01 Oct 2011 00:00:00 GMT-05:0000004045-201110000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/11000/OASIS_C_Importance_of_Accurate_Pressure_Ulcer.4.aspx
This is Part II of an article describing an educational initiative by certified wound, ostomy, and continence nurses to strengthen clinical and documentation skills related to the Outcome and Assessment Information Set (OASIS)-C M items. Part I, published in Home Healthcare Nurse in April 2011 (vol. 29, issue 4, pp. 233–245), reviewed the fundamentals of wound assessment, wound healing, and OASIS-C wound terminology. The focus of this article is to show the connection between the clinical assessment, interventions, documentation, and the impact on quality outcomes and reimbursement. Because of the scope of this topic and the emphasis given to the problem of pressure ulcers by varying sectors of healthcare, including hospitals and nursing homes, this article focuses on pressure ulcers and OASIS-C.]]>Tue, 01 Nov 2011 00:00:00 GMT-05:0000004045-201111000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/02000/Polypharmacy_in_Older_Adults_at_Home__What_It_Is.4.aspx
Polypharmacy—the use of more medications than are clinically indicated—is a problem that affects many older adults. Adults aged 65 years and older make up approximately 13% of the population, but they consume nearly one third of all prescriptions dispensed. Older adults are more prone to adverse drug reactions and drug–drug interactions because of physiological changes and multiple comorbidities. It can be difficult to address the problem because there are many contributing factors, including multiple prescribers and specialists, the use of multiple pharmacies, and gaps in communication. The initial step is to avoid the problem. However, when this does not work, it must be identified and then treated by carefully changing medication regimens to improve the quality of care to patients. The home healthcare nurse has an essential role in this process, which will be reviewed in this article. Some of the barriers that may be encountered and examples of communication with providers are included.]]>Fri, 01 Feb 2013 00:00:00 GMT-06:0000004045-201302000-00004http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/02000/The_Fundamentals_of_Hospice_Compliance__What_Is_It.9.aspx
This article, Part 1 of a 2-part series, provides an overview of the current Medicare compliance climate and its implications for hospice providers. Content focuses on the 7 elements of a comprehensive compliance framework as defined by the Health and Human Services Office of the Inspector General in its 1999 Compliance Guidance for Hospices. A brief case example is provided and serves to set the stage for Part 2, which will explore hospice-specific risk areas and specific risk-reduction strategies.]]>Wed, 01 Feb 2012 00:00:00 GMT-06:0000004045-201202000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/04000/Wound_Assessment___Management__Wound_Care.8.aspx
No abstract available]]>Fri, 01 Apr 2011 00:00:00 GMT-05:0000004045-201104000-00008http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/02000/An_Evidence_Based_Pediatric_Fall_Risk_Assessment.9.aspx
No abstract available]]>Tue, 01 Feb 2011 00:00:00 GMT-06:0000004045-201102000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/02000/Recent_Research_on_Care_Coordination.10.aspx
Abstract: Patients with multiple chronic conditions have been shown to have significant Medicare expenditures. Care coordination programs have been implemented targeting this population by organizations striving to achieve the triple aim of (a) improving healthcare quality, (b) improving the patient experience, and (c) reducing costs. Outcomes of these programs have been mixed. This research brief profiles four published articles that address different aspects of care coordination. Readers are encouraged to access the full articles to learn more details about the intervention strategies and findings described in these articles.]]>Sun, 01 Feb 2015 00:00:00 GMT-06:0001845097-201502000-00010http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/04000/Palliative_Wound_Care,_Part_2__Application_of.3.aspx
In part 1 of this 2-part series, we discussed principles of palliative care to help understand the goals of treatment in developing a plan of care. This article, Part 2, aims to provide knowledge of practical topical wound management by common wound etiologies and symptoms among persons who would benefit from palliative wound care.]]>Tue, 01 Apr 2014 00:00:00 GMT-05:0000004045-201404000-00003http://journals.lww.com/homehealthcarenurseonline/Fulltext/2013/03000/Hoarding_in_the_Home__A_Toolkit_for_the_Home.6.aspx
Hoarding is a mental health disorder characterized by difficulties with discarding possessions, yielding cluttered and chaotic home environments that can pose significant safety concerns, impairment to functioning, and distress for those who live in and encounter these situations. Understanding the condition and the strategies available to support individuals who hoard are important skills for the home care provider and are described here in the context of one community organization's response via the development of a Community Clutter and Hoarding Toolkit.]]>Fri, 01 Mar 2013 00:00:00 GMT-06:0000004045-201303000-00006http://journals.lww.com/homehealthcarenurseonline/Fulltext/2015/02000/A_Motivational_Interviewing_Education_Intervention.5.aspx
Abstract: The ability of registered nurses to communicate well with their patients is foundational to patient-centered care, the management of chronic illness, and general healthcare. It is also vital to the nurse–patient relationship. Nurses, however, tend to identify with their patients' physical needs and rely heavily on the technical skills with which they feel more comfortable. This lack of ability to communicate well with their patients can result in poor nurse–patient understanding, can lead to poor patient outcomes, and a lack of patient engagement and involvement in their care. Motivational interviewing (MI), a patient-centered manner of communication, is a means to direct the nurse–patient interaction in a way that is patient centered. Brief education of MI has shown to be effective in increasing the self-efficacy of nurses in their ability to communicate well with their patients. In 2 geographically diverse Pennsylvania home care settings, MI education was provided to 20 nurses. The educational intervention was designed to increase the self-efficacy of nurses regarding their ability to affect the negative behaviors of chronically ill patients. A pretest and posttest was administered to the nurse participants to determine the effectiveness of the educational intervention. This evidence-based education increased the nurses' overall communication self-efficacy by 25%.]]>Sun, 01 Feb 2015 00:00:00 GMT-06:0001845097-201502000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/03000/One_Home_Health_Agency_s_Quality_Improvement.9.aspx
"Decreasing rehospitalization among home care patients felt like being held responsible for factors many of which are outside of our control when too many external forces really determined rehospitalization decisions."]]>Tue, 01 Mar 2011 00:00:00 GMT-06:0000004045-201103000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/07000/Say_Goodbye_to_Wet_to_Dry_Wound_Care_Dressings_.9.aspx
No abstract available]]>Fri, 01 Jul 2011 00:00:00 GMT-05:0000004045-201107000-00009http://journals.lww.com/homehealthcarenurseonline/Fulltext/2011/10000/Assessment_of_Surgical_Wounds_in_the_Home_Health.5.aspx
No abstract available]]>Sat, 01 Oct 2011 00:00:00 GMT-05:0000004045-201110000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2014/05000/Pain_Assessment_and_Management_Strategies_for.1.aspx
No abstract available]]>Thu, 01 May 2014 00:00:00 GMT-05:0000004045-201405000-00001http://journals.lww.com/homehealthcarenurseonline/Fulltext/2010/11000/Improving_Heart_Failure_in_Home_Care_with_Chronic.5.aspx
Home Health Compare rates for Emergent Care and Acute Hospitalization increased undesirably for Athens Regional Home Health. Data revealed that the increase was due to heart failure exacerbation. It was hypothesized that a chronic disease management program with telemonitoring, to include chest fluid bioimpedance, would allow for earlier intervention, thus preventing emergency department visits and acute care readmissions. This article describes the agency's performance improvement initiative that resulted in a decrease in these rates while improving patient outcomes and increasing agency referrals.]]>Mon, 01 Nov 2010 00:00:00 GMT-05:0000004045-201011000-00005http://journals.lww.com/homehealthcarenurseonline/Fulltext/2012/03000/Adults_with_Sickle_Cell_Disease__An.7.aspx
The complexity of caring for adults with sickle cell disease (SCD) strains the confines of a care-segregated medical system. As treatment protocols have dramatically improved since 1990, many patients with SCD are now living well beyond their 6th decade of life. This improved survival rate presents opportunities and challenges for the home healthcare nurse in the management of adult patients with SCD. The home healthcare nurse is essential in the coordination of interdisciplinary health team members to reduce pain episodes and the potentially catastrophic complications of renal failure, pulmonary disease, and cardiovascular events. In addition, the home healthcare nurse serves as patient advocate for the transition fromacute care to home, as well as advocate forhealthcare maintenance of vision, musculoskeletal involvement, and social and psychological support. This article seeks to provide a viable network for home healthcare nurses to establish self-care management and support of the adult patient with SCD.]]>Thu, 01 Mar 2012 00:00:00 GMT-06:0000004045-201203000-00007